Organization
SPIRIT LAKE TRIBE
Active
Other names
Spirit Lake Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ARLENE KRULISH (CEO)
(701) 766-1607
Entity
Organization
Contact information
Practice address
3883 74TH AVE NE, FORT TOTTEN, ND 58335-0309
(701) 766-1600
(701) 766-1630
Mailing address
PO BOX 309, FORT TOTTEN, ND 58335-0309
(701) 766-1600
(701) 766-1630
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1470084
—
ND
Enumeration date
02/26/2020
Last updated
02/26/2020
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